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Hinyokika Kiyo. Acta Urologica Japonica Aug 2014We conducted a retrospective review of 16 patients who were diagnosed with enterovesical fistula in our hospital between January 2000 and July 2013. The patient's median...
We conducted a retrospective review of 16 patients who were diagnosed with enterovesical fistula in our hospital between January 2000 and July 2013. The patient's median age was 74 years old and 4 were female. Most of the chief complaints were pneumaturia and fecaluria. There was a vesicosigmoidal fistula in 12 patients, an ileovesical fistula in 2, and a rectovesical fistula in 2. The main underlying cause was diverticulitis in 9 patients and a sigmoid colon carcinoma in 3. Diagnoses were made based on the findings of cystoscopy, barium enema, abdominal computed tomography and so on. Treatment varied in each case depending on the etiology and the patient's condition. The procedure was mostly open surgery, but laparoscopic sigmoidectomy was performed preserving the bladder in the two most recent cases.
Topics: Aged; Aged, 80 and over; Cystoscopy; Female; Humans; Intestinal Fistula; Male; Middle Aged; Rectal Fistula; Retrospective Studies; Urinary Bladder Fistula
PubMed: 25179986
DOI: No ID Found -
BJR Case Reports 2017Enterovesical fistula is an abnormal communication between the urinary bladder and intestine. Diverticulitis is the most common aetiology, accounting for approximately...
Enterovesical fistula is an abnormal communication between the urinary bladder and intestine. Diverticulitis is the most common aetiology, accounting for approximately 50-70% of cases, and malignancy is the second most common cause, accounting for approximately 20% of cases. However, most patients are hospitalized because of urinary symptoms. The disease can be misdiagnosed if patients have been symptomatic for a long time before the diagnosis is made. Detection of enterovesical fistula and the underlying disease is important. However, the optimal diagnostic methods have not been clarified. CT scan is the most sensitive diagnostic modality, but should be backed up with cystoscopy, cystography, colonoscopy and barium enema.
PubMed: 30363344
DOI: 10.1259/bjrcr.20150124 -
Cureus Mar 2024Crohn's disease is an inflammatory bowel disease of unknown etiology. It is characterized by intra- and extra-intestinal complications. It is a frequent cause of...
Crohn's disease is an inflammatory bowel disease of unknown etiology. It is characterized by intra- and extra-intestinal complications. It is a frequent cause of uroenteric fistulas. They are mostly symptomatic and occur after several years of the evolution of Crohn's disease. The pneumaturia and fecaluria are the most significant symptoms for their presence. They are usually poorly tolerated and require surgical treatment. We report the case of an enterovesical fistula revealing Crohn's disease during endoscopic resection of a bladder pseudotumor in a generally impaired patient. Crohn's disease should be evocated when histology is not relevant for a bladder pseudotumor or a rectovesical fistula. The discovery of an isolated bladder pseudotumor should suggest the diagnosis in the context of weight loss and chronic diarrhea. Enterovesical fistulas are uncommon but potentially dangerous complications of Crohn's disease. Abdominal CT scans and cystoscopy are the most commonly used diagnostic modalities. Surgical treatment seems to be unavoidable in most cases although medical treatment could also benefit a small cohort of patients.
PubMed: 38646343
DOI: 10.7759/cureus.56690 -
JSLS : Journal of the Society of... 2019Entero vesical fistulas (EVFs) are an uncommon complication mainly of diverticular disease (70%) and less commonly of Crohn's disease (10%). Only about 10% are caused by...
BACKGROUND AND OBJECTIVE
Entero vesical fistulas (EVFs) are an uncommon complication mainly of diverticular disease (70%) and less commonly of Crohn's disease (10%). Only about 10% are caused by malignancies. At this time, it is unclear whether the laparoscopic approach can be routinely proposed as a safe procedure for patients with EVF. The aim of this study was to assess the feasibility and safety of laparoscopic surgery in the treatment of EVFs in patients with complicated diverticular and Crohn's disease.
METHODS
All patients with the diagnosis of EVF who underwent laparoscopic surgery were identified from prospective collected data based in two institutions between 2007 and 2017. Patients with malignancy were excluded. Recorded parameters included operative time, conversion to open surgery, the presence of a protective loop ileostomy, perioperative complications, number of units of blood transfused, postoperative course, and histologic findings.
RESULTS
Seventeen patients were included in the study: 10 patients with a colo-vesical fistula due to diverticular disease, and 7 patients with an ileo-vesical fistula due to Crohn's disease. There were no conversions to open surgery and none of the patients needed a protective ileostomy. The bladder was sutured in 12 patients (70%). No intra-operative complications were met, and no blood transfusions were needed; there were no anastomotic leaks, nor mortality in both groups.
CONCLUSIONS
The laparoscopic approach for benign EVF in selected patients is both feasible and safe in the hands of experienced surgeons with extensive expertise in laparoscopic surgery.
Topics: Adult; Aged; Anastomosis, Surgical; Crohn Disease; Diverticular Diseases; Female; Follow-Up Studies; Humans; Intestinal Fistula; Laparoscopy; Male; Middle Aged; Postoperative Complications; Prospective Studies; Urinary Bladder Fistula; Young Adult
PubMed: 30740013
DOI: 10.4293/JSLS.2018.00095 -
BMC Surgery Jul 2019Enterovesical fistula (EVF) is a abnormal connection between the intestine and the bladder. The aim of the study was to analyze whether closure of the defect in the...
BACKGROUND
Enterovesical fistula (EVF) is a abnormal connection between the intestine and the bladder. The aim of the study was to analyze whether closure of the defect in the bladder wall during surgery is always necessary.
METHODS
Fifty-nine patients with benign EVF undergoing surgical treatment were enrolled. A one-stage surgical procedure was performed in all patients. After the separation of the diseased bowel segment, methylene blue was introduced. Through a catheter into the bladder. Only patients with urinary bladder leakage were sutured.
RESULTS
The most common intestinal fistula involving the urinary bladder was colovesical fistula, observed in 53% of cases. Two-thirds of patients had diverticular disease as the underlying pathology. There was no relationship between suturing of the bladder and perioperative complications. Recurrent EVF was observed in one patient with bladder suturing and in two patients without suture.
CONCLUSIONS
These findings suggest that closure of the bladder defect is not necessary in cases where a leak is not demonstrated from the bladder intraoperatively. This study is limited by its retrospective design and small numbers and a randomized controlled trial is recommended to answer this question definitively.
Topics: Adult; Aged; Female; Humans; Intestinal Fistula; Male; Middle Aged; Retrospective Studies; Suture Techniques; Urinary Bladder; Urinary Bladder Fistula
PubMed: 31286905
DOI: 10.1186/s12893-019-0542-4 -
Oncology Letters Jul 2016Enterovesical fistula (EVF) is a rare complication of diverticulitis, as well as Crohn's disease, intestinal malignancy, radiotherapy and trauma. EVF formation is...
Enterovesical fistula (EVF) is a rare complication of diverticulitis, as well as Crohn's disease, intestinal malignancy, radiotherapy and trauma. EVF formation is associated with inflammation of the involved bowel segments. The current study presents the case of a 35-year-old man with non-Hodgkin's lymphoma who developed pneumaturia, fecaluria and recurrent urinary tract infections following chemotherapy, accompanied by regressive change of the lymphoma. Abdominal computed tomography scans revealed that the terminal ileum had adhered to the bladder wall. The patient underwent exploratory laparotomy and partial resection of the terminal ileum, and EVF was confirmed. Histological examination revealed an inflammatory response but no evidence of residual lymphoma. The diagnosis of EVF is occasionally difficult and requires appropriate radiographic examination. Surgical treatment is recommended.
PubMed: 27347146
DOI: 10.3892/ol.2016.4561 -
Revista Espanola de Enfermedades... Sep 2013
Topics: Crohn Disease; Digestive System Surgical Procedures; Endometriosis; Female; Humans; Intestinal Fistula; Intestinal Obstruction; Middle Aged
PubMed: 24274454
DOI: 10.4321/s1130-01082013000800015 -
Asian Journal of Surgery Feb 2023
Topics: Humans; Urinary Bladder; Urinary Bladder Fistula; Intestinal Fistula; Laparoscopy
PubMed: 35999104
DOI: 10.1016/j.asjsur.2022.08.022 -
Annals of Medicine and Surgery (2012) Jan 2022The incidence of Enterovesical Fistula (EVF) is relatively low. Currently, there is no agreement about the best methods for EVF management. This study was performed to...
INTRODUCTION
The incidence of Enterovesical Fistula (EVF) is relatively low. Currently, there is no agreement about the best methods for EVF management. This study was performed to investigate the characteristics of EVF to find the optimal diagnostic and management pattern.
METHODS
Data were collected retrospectively from the medical record at Cipto Mangunkusumo Hospital. Patients diagnosed with EVF between January 2014 and April 2019 were included. They were evaluated for demographics, characteristics, diagnostic modalities, and treatment modalities.
RESULTS
From 41 patients, 26 (63.3%) are male, and 15 (36.6%) are female. Peak incidence was 51-60 years old. The most common symptoms are fecaluria found in 32 (78%) patients. The common etiology is gastrointestinal cancer found in 17 (41.5%) patients, followed by gynecologic cancer and diverticulitis found in both 9 (22%) patients. The rectovesical fistula was seen in 25 (61%) patients with an advanced stage rectosigmoid cancer, followed by colovesical in 14 (34.1%) of patients with sigmoid diverticulitis (p 0.038). The common diagnostic modalities performed are cystoscopy in 32 (78%), followed by colonoscopy in 11 (26.8%) patients. The preferred modalities that were used in most cases were surgery in 35 (85.4%) patients. A two-stage surgical approach was used in 28 (68.3%) patients.
CONCLUSION
The incidence of EVF is uncommon. Malignancy was the leading cause of EVF in this study. Combined diagnostic modalities are recommended in EVF cases. The two-stage surgical approach was the preferred modality. Further prospective studies are mandatory to analyze this condition.
PubMed: 35028134
DOI: 10.1016/j.amsu.2021.103102 -
Cureus Sep 2022Crohn's disease (CD) is an inflammatory bowel disease affecting any portion of the gastrointestinal tract, usually the terminal ileum and the colon, with clinical...
Crohn's disease (CD) is an inflammatory bowel disease affecting any portion of the gastrointestinal tract, usually the terminal ileum and the colon, with clinical manifestations such as diarrhea, fever, and weight loss. Clinical presentation of CD may include complications such as enterovesical fistulas, abscesses, strictures, and perianal disease. CD also classically presents with "skipping lesions," unlike ulcerative colitis (UC), which presents with continuous lesions. It can manifest with a wide range of extra-intestinal symptoms such as pyoderma gangrenosum, aphthous stomatitis, episcleritis, uveitis, and arthritic disease. Such a wide range of presentations leads to diagnostic difficulties, as seen in this case. Treatment modalities include steroids, antibiotics, and surgical removal of affected parts, depending on the extent of the disease. Here, we present a case of a young male who presented with manifestations of mesenteric lymphadenitis and had an intraluminal cecal mass causing obstructive symptoms, and was subsequently diagnosed with CD.
PubMed: 36299929
DOI: 10.7759/cureus.29431